0:00

What about sequential screens?

0:03

What about how often should you have them?

0:05

Should you have them every 2 years?

0:08

What happens after you've had one?

0:10

So we want to look into this a little bit.

0:12

This is one cohort study that came from

0:15

Korea, and this was almost 2000 women undergoing

0:18

about 3000 exams, and they were

0:21

a mix of mostly high or intermediate risk.

0:25

There were some average-risk women with

0:26

dense breasts, but a very small number.

0:29

So remember higher-risk women

0:31

looking at the typical outcomes.

0:33

And this is interesting because their

0:34

results are important, but very different

0:38

from what we found in average-risk women.

0:40

And I'll show you that they found 38 cancers,

0:44

29 of those detected by abbreviated MR, but nine

0:48

false negatives. Of the nine false negatives,

0:51

they were all node-negative.

0:52

And seven of those nine were not seen by the

0:55

abbreviated MR, but were seen by another

0:57

modality and two were true interval cancers.

1:00

So, if you look at their cancer detection

1:03

rates here and their sensitivity

1:05

and specificity, their cancer detection rates per

1:08

1000 screens of the MRs are much less than

1:12

what we've been seeing, which is interesting.

1:15

Um, 10.7 in year 3, 7 or so per 1000 in year 1, 8.6in year 2.

1:16

31 00:01:20,730 --> 00:01:22,410

1:22

And the sensitivity is not as great

1:25

as what we have been seeing in some

1:27

of our studies, but the specificity is

1:28

higher because they're biopsying less.

1:31

But also sensitivity is less, so very,

1:34

very interesting, somewhat different

1:36

results than what we've had. Biopsy rate,

1:38

very low, short-term follow-up rate.

1:40

We hate those categories.

1:42

3 is also low, but I just wanted you to see this now.

1:45

I want you to see data that

1:47

my colleagues and I presented

1:50

last year on our sequential rounds.

1:54

Now, we had a total of about 2,1800 women who had

2:00

more than one study, and we looked at the baseline

2:03

results of their abbreviated MR versus their

2:06

subsequent rounds, and you can see the cancers.

2:10

You can see the cancer detection rates,

2:13

and we maintained a pretty high cancer

2:15

detection rate on the subsequent round: 16.8,

2:20

and subsequent versus 17.6. Remember, this is looking at

2:25

the women who’ve had more than one MR.

2:27

So, not our whole volume of women that

2:29

I presented to you earlier that had a

2:32

24.7 per 1000 cancer detection

2:34

rate, but this is pretty good.

2:37

So, how frequent were these?

2:40

Between baseline and subsequent,

2:42

the mean interval between the consecutive

2:45

studies was actually a little over a year.

2:47

It was 755 days.

2:50

So they weren’t getting them in general every

2:52

year, but a little bit longer than that.

2:53

And I think this is something that we

2:55

need to look at, you know, perhaps.

2:57

The supplemental screening with

2:59

MR should be yearly for premenopausal women.

3:02

Maybe as women age, it may

3:04

become every other year.

3:06

Of course, it's something that we need

3:07

to consider, but there was no significant

3:10

difference in the cancer detection rate

3:11

on our baseline versus subsequent studies.

3:14

Fascinating.

3:15

There was a trend, as you can imagine of higher PPV 2 and 3.

3:18

81 00:03:18,575 --> 00:03:18,804

3:18

83 00:03:20,174 --> 00:03:21,994 that's the positive predictive value.

3:21

So calling something, um.

3:24

Um, actionable.

3:26

Um, it makes sense if you've got a

3:28

prior to compare your PPV 2 and 3 88 00:03:31,285 --> 00:03:32,605 should become better because you've

3:32

got like a baseline to compare to.

3:34

I hope that makes sense.

3:35

92 00:03:37,465 --> 00:03:40,855 Birads 3% again got better because

3:40

you had something to compare to.

3:43

95 00:03:44,295 --> 00:03:46,685 Very, very interesting compared to the

3:46

data presented in that prior Korean

3:48

paper, but this cancer detection rate was

3:51

maintained and here's the type of cancers.

3:54

The majority of the cancers were early

3:56

stage stage 0 or stage 1, and you can

4:00

see that also on the subsequent rounds.

4:02

You're not seeing any high

4:03

grade 1 stage 2, 3 and 4.

4:06

There was 1 stage 3 at baseline imaging

4:09

in this small less than 2000 group.

4:11

That we had at our site.

4:13

We're looking at, uh, writing this

4:14

up, um, anytime sometime soon.